Diabetes Goes Undiagnosed To Be Later Spot By ED Screening


One of the diabetic screening programmes within an emergency department lets the patient identify undiagnosed disease as well as prediabetes.

A Chicago hospital emergency department’s pilot study can very well pave the way for the overall development of diabetic screening programs. It is estimated that worldwide, around 415 million people are suffering from diabetes, and the startling part is that a whopping 46% of those with this condition aren’t even aware of it.

Although there is an emergency department that is created in order to give critical access to healthcare, it is also an opportunity to pinpoint and thereafter link patients to other services as well. For instance, the screening services that exist within the emergency department have been created for HIV as well as for disorders related to substance use. Moreover, one Australian study from 2016 that involved regular ED HbA1c testing in a location that had a high penetration of diabetes put out the fact that an initiative such as this was indeed a feasible way to pick out those with the undiagnosed disease and also provided an opportunity to enhance patient care. The notion has been recognised, especially in the US, that ethnic minorities as well as low-income adults have been inadvertently affected by diabetes, leading to increased diabetic complications and mortality risk.

Because of this, in the present study, scientists examined if the pilot programme concerning diabetes screening performed within an emergency department would enable the condition’s identification, especially in those from ethnic minorities.

The researchers have come up with a best practice alert that is built into an electronic medical record that flagged patients from ED who had the risk of diabetes i.e. patients aged 45 years or more or even those falling under the 18-44 year old bracket having a BMI of 25 or higher with no history of diabetes or HbA1c analysis in the last three years. Thereafter, the team looked to get in touch with all potentially eligible individuals.

Detection of diabetes and the diabetic screening programme

Overall, 352 apt candidates with a mean age of 52.2 years, of whom 54.5% were female, were identified. Of the group, 264 were detected as having prediabetes, i.e., a HbA1c level of up to 6.4%, and 88 had a HbA1c of more than 6.5%. 62 had severe diabetes with an HbA1c level of more than 10%. Interestingly, within the group, almost 75% had no prior diagnosis of prediabetes or diabetes. Although the scientists were able to successfully pinpoint patients with undiagnosed diabetes, especially among the ethnic minorities, there were still questions that loomed around the value of taking up diabetic screening in EDs in other areas and whether such a step would prove to be cost-effective or not.